Different countries have their own ways in which they offer their health care to their people. Many countries have developed mechanisms in which they make sure that the greatest number of people access medical care services in effective ways despite of their economic or social classes. This paper focuses on health care in Germany.

In Germany, there is policy, which requires everyone who earns less that 3862 Euros per month to join one the three hundred statutory sickness funds that are found in the country. This is with exception of permanent civil servants and the self-employed people. Those people who lie above the mandatory insurance threshold have the room to opt out of the system offered by the state. Most of them buy private insurance although there are also those who decide to remain in the state system. In the country, it is estimated that ten percent of the population are insured voluntariry.The sickness funds in the country are required to be self-sufficient financially. The premiums are usually set as a percent of the total income. The premiums are usually subtracted from the pay where the employer and the employee pay half each (Kirch, 2008).
Since the 1990’s the government has tried to increase competition among the insurers. This is aimed at enhancing provision of high quality services by the insurance companies. The competition has made the insurance to offer services that are affordable to many people. It is possible to make a comparison, of which insurer offers the best services from the Internet, magazines and the ranking, which is usually done by independent consumer organizations. This has led to large scale shift from the traditional dominant funds. However, this competition cannot be compared with the one that exist in the United States of America. Those people who have a great portion of their pay cut each month becomes the patients who demand to have high quality medical services, which can be, compared with the value of the money that they contribute for the services. They tend to go shopping for the best doctors (Tartaglia, 2005). This is because they do not pay any amount of money as they receive the medical services. Their payments are usually reimbursed by the sickness funds. This reimbursement is usually done through their regional physicians associations. However, those people who have private insurance pay by use of invoice for the treatments that they receive. In the provision of medical services, a distinction that is made between those people who have worked and those have who have never worked. Those people who have previously worked are included in the national insurance system. However, it is nit the employers who pays for the medical services of these people but there are agencies who pay. For those people who are unemployed and have never worked, there is social fund where the provision is made. The social funds arrange cover directly with health specialists (Wolper, 2004).

In Germany hospital are diversely owned. This enhances further competition and constant efforts that are made by the health providers to raise the standards of their services. For instance, in 2002, almost fifty-four percent of hospital beds are owned by the public sector, thirty eight percent were owned by the private non-governmental organizations, while eight percent were privately owned for profit bodies. In Germany, there is no queueing, which is common in many countries in order to see a specialist. Germans have the freedom to see and get services from any specialist that they like. They can visit various hospitals or they book for appointments that are booked instantly by the physicians. Consumers also have the right to penalize for any bad service that they may receive. There is a well established system that allows all the patients to have the most effective serves at the appropriate time in all times (Tartaglia, 2005). About half of medical specialists in Germany have their practice outside the hospitals. Most of the hospitals in the country do not provide out patient services. What happens is that there are very many independent clinics, which have sophisticated diagnosis equipments, which makes them to offer high quality medical services. There are also many health specialists in Germany. It is estimated that there are 2.3 practicing specialist out of one thousand people. This is high as compared to other countries for example UK that has 1.5 practicing specialists out of one thousand people (Kirch, 2008).

There are two problems that health care in Germany face at the moment. For instance, there is a shortage of nurses and many Germans have the feeling that the medical health care services are expensive. However, there are reforms that are being carried out in the health care system in the country. For instance, there was the introduction of charges for non-prescription drugs and the elimination of the free treatments for example health farm visits and free tax rides to health centers. These reforms are aimed at reduction in premiums from an estimated average of fourteen to thirteen percent of gross wages annually (Wolper, 2004).


References
Kirch, W. (2008) Encyclopedia of Public Health, New York, Springer.

Tartaglia, R. (2005) Healthcare Systems Ergonomics and Patient Safety, New York, Taylor & Francis.

Wolper, L. (2004) Health care administration: planning, implementing, and managing organized delivery systems, 4th edition, New York, Jones & Bartlett Learning.